TY - JOUR
T1 - Effects of unilateral upper limb training in two distinct prognostic groups early after stroke
T2 - The EXPLICIT-stroke randomized clinical trial
AU - Kwakkel, Gert
AU - Winters, Caroline
AU - Van Wegen, Erwin E H
AU - Nijland, Rinske H M
AU - Van Kuijk, Annette A A
AU - Visser-Meily, Anne
AU - De Groot, Jurriaan
AU - De Vlugt, Erwin
AU - Arendzen, J. Hans
AU - Geurts, Alexander C H
AU - Meskers, Carel G M
PY - 2016
Y1 - 2016
N2 - Background and Objective. Favorable prognosis of the upper limb depends on preservation or return of voluntary finger extension (FE) early after stroke. The present study aimed to determine the effects of modified constraint-induced movement therapy (mCIMT) and electromyography-triggered neuromuscular stimulation (EMG-NMS) on upper limb capacity early poststroke. Methods. A total of 159 ischemic stroke patients were included: 58 patients with a favorable prognosis (>10° of FE) were randomly allocated to 3 weeks of mCIMT or usual care only; 101 patients with an unfavorable prognosis were allocated to 3-week EMG-NMS or usual care only. Both interventions started within 14 days poststroke, lasted up until 5 weeks, focused at preservation or return of FE. Results. Upper limb capacity was measured with the Action Research Arm Test (ARAT), assessed weekly within the first 5 weeks poststroke and at postassessments at 8, 12, and 26 weeks. Clinically relevant differences in ARAT in favor of mCIMT were found after 5, 8, and 12 weeks poststroke (respectively, 6, 7, and 7 points; P
AB - Background and Objective. Favorable prognosis of the upper limb depends on preservation or return of voluntary finger extension (FE) early after stroke. The present study aimed to determine the effects of modified constraint-induced movement therapy (mCIMT) and electromyography-triggered neuromuscular stimulation (EMG-NMS) on upper limb capacity early poststroke. Methods. A total of 159 ischemic stroke patients were included: 58 patients with a favorable prognosis (>10° of FE) were randomly allocated to 3 weeks of mCIMT or usual care only; 101 patients with an unfavorable prognosis were allocated to 3-week EMG-NMS or usual care only. Both interventions started within 14 days poststroke, lasted up until 5 weeks, focused at preservation or return of FE. Results. Upper limb capacity was measured with the Action Research Arm Test (ARAT), assessed weekly within the first 5 weeks poststroke and at postassessments at 8, 12, and 26 weeks. Clinically relevant differences in ARAT in favor of mCIMT were found after 5, 8, and 12 weeks poststroke (respectively, 6, 7, and 7 points; P
KW - constraint-induced movement therapy (CIMT)
KW - electromyography-triggered neuromuscular stimulation (EMG-NMS)
KW - randomized controlled trial (RCT)
KW - stroke
KW - upper limb
UR - http://www.scopus.com/inward/record.url?scp=84987730775&partnerID=8YFLogxK
U2 - 10.1177/1545968315624784
DO - 10.1177/1545968315624784
M3 - Article
AN - SCOPUS:84987730775
SN - 1545-9683
VL - 30
SP - 804
EP - 816
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 9
ER -